PubMed · 12956341
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Barry Garsson. 2003. Vertical root fractures.. https://doi.org/10.14219/jada.archive.2003.0304
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The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p > 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.
This section deals with the important issue of impacted teeth. Impacted canines in Class I uncrowded cases can be improved by removal of the deciduous canines. There is some evidence that this is true for both buccal and palatal impactions. Treatment of impacted canines is lengthy and potentially hazardous. Interceptive measures are effective and preferred to active treatment. Supernumerary teeth may also cause impaction of permanent incisors, their early diagnosis and appropriate treatment is essential to optimise final outcomes. If there are any doubts about impacted teeth it is better to refer too early than too late, this latter option may unnecessarily extend the length of treatment as well as the treatment required.
OBJECTIVES: To determine the incidence and extent of overeruption in unopposed posterior teeth; to determine the incidence of occlusal interferences associated with unopposed posterior teeth; and to detect an association between the extent of overeruption and the presence of occlusal interference. DESIGN: The study was a single centre clinical retrospective analysis. Setting The setting was in the Combined Care Clinic of Leeds Dental Institute. The patients were undergoing routine restorative care by final year undergraduate dental students during 2000. SUBJECTS AND METHODS: All patients over18 years of age with one or more unopposed posterior tooth, were invited to participate. A sample group of 120 subjects were recruited. A clinical occlusal examination was carried out and the presence of initial retruded contact position (RCP) contacts and excursive interferences were recorded. Study models were made and digitally scanned. OUTCOME MEASURES: Measurements of overeruption from the curve of Spee were made from the images obtained, by a single observer. Reliability of the measurements was assessed by means of a Bland Altman Plot. The presence and site of RCP contacts and excursive interferences were recorded by a single observer. Reliability of the measurements was assessed by means of Kappa scores. The association between overeruption and the presence of occlusal interference was examined using Spearmans Correlation Coefficient. RESULTS: A total of 120 subjects were recruited, with a total of 155 unopposed sites. Eighty-one of the sites belonged to male subjects, 74 to female subjects. The mean age of the group was 50.9 years, Standard deviation 13.9 Eighty-three per cent of sites displayed overeruption (95% CI 78-90), ranging from under 0.5 mm to 5.4 mm. The reliability of the observations was found to be good. A total of 51.6% (95% CI 44-60) of unopposed teeth were involved in RCP contacts or excursive interferences. Thirty-two sites were involved in more than one contact or interference. The intra-examiner agreement was found to be good, using Kappa. The findings of the Spearman's correlation, show that if an association exists between overeruption and occlusal interference, it is weak, and of no statistical significance. CONCLUSIONS: Eighty-three per cent of unopposed teeth are likely to overerupt, and the extent of the overeruption may be marked. The incidence and extent of overeruption is of clinical significance, not only in terms of treatment planning to prevent undesirable vertical movement, but also in the restoration of the edentulous space. The reliability of observations made in the study was found to be good, justifying the methodology. Fifty-one point six per cent of unopposed teeth are likely to be involved in RCP contacts or excursive interferences. The incidence is of clinical significance when planning the restoration of unopposed teeth, or the associated edentulous space. Only a weak statistical association was demonstrated between the degree of overeruption and the presence of occlusal interferences.